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Guides through decision to use medicine to quit smoking. Lists benefits and risks. Discusses varenicline (Chantix), bupropion (Zyban), and nicotine replacement products such as patches, gum, and inhalers. Includes interactive tool to help you decide.

Quitting Smoking: Should I Use Medicine?

You may want to have a say in this decision, or you may simply want to follow your doctor's recommendation. Either way, this information will help you understand what your choices are so that you can talk to your doctor about them.

Your options

Use medicine to help you quit smoking. This may include
nicotine replacement products.

Don't use medicine.

Key points to remember

Using medicines and nicotine replacement products (patches, gum, lozenges, and inhalers) can double your chances of quitting
smoking.1 They can relieve
nicotine craving and withdrawal symptoms.

Getting counseling, along with using medicine, can increase your
chances of quitting even more.

If you smoke fewer than 10
cigarettes a day, you may not need medicines to help you quit smoking.

It's rare for someone to get addicted to nicotine medicines,
because the nicotine is released slowly at low levels into your bloodstream.

Nicotine replacement products may cause some side effects, such as problems with sleep or red and itchy skin with the patch. Medicines in pill form
can cause nausea, dry mouth, and trouble sleeping. For most people, the side
effects aren't bad enough to make them stop using the medicines.

Nicotine medicines have less than half of the nicotine than cigarettes. And by
itself, nicotine is not nearly as harmful as smoking. The tars, carbon
monoxide, and other toxic chemicals in tobacco cause the harmful effects.

Many insurance companies will pay for all or part of the cost of
medicines used to quit smoking.

Your doctor may prescribe
varenicline (Chantix) or bupropion (Zyban) to help you cope with cravings for
tobacco. These medicines are pills that don't contain nicotine. You also can
use nicotine replacement products, which do contain nicotine.

Medicines that don't have nicotine

Varenicline (Chantix) blocks the effects of nicotine and reduces cravings and
withdrawal symptoms. If you start smoking again while
you are taking the medicine, you won't feel as satisfied. This improves your
chances of quitting. You start taking the medicine about a week before you quit
smoking, and you take it for 12 to 24 weeks. You take it 2 times a day, after
meals.

Bupropion SR (Zyban) can help
balance chemicals in your brain to reduce your withdrawal symptoms. Doctors
also prescribe this medicine (under the brand name Wellbutrin) to treat
depression. But it can help you stop smoking even if
you don't have depression. You start taking bupropion daily about 1 to 2 weeks
before you quit smoking. You
keep taking it for 7 to 12 weeks after you stop smoking.

Nicotine replacement products

Nicotine replacement gives your body
some nicotine to help reduce withdrawal symptoms and cravings. Nicotine is
addictive. But this treatment has about one-third to one-half the amount of
nicotine in most cigarettes. It also delivers the nicotine slowly, so it rarely causes addiction. And these products don't have the
harmful tars, carbon monoxide, and other toxic chemicals that are in tobacco.

An inhaler has a holder that contains nicotine. It delivers a
puff of nicotine vapor into your mouth and throat.

Nicotine nasal spray (Nicotrol) is another nicotine replacement. But because of its side effects, it is not widely used. See your doctor about this medicine.

You can buy nicotine gum, patches, and lozenges without a
prescription. You need a prescription to buy inhalers. You may be able to use a
couple of these products at the same time, such as a patch and gum. But talk to
your doctor first to make sure it's okay to mix nicotine medicines. People
younger than age 18 can't buy the
over-the-counter products, but a doctor may prescribe
them.

Talk to your doctor if you're pregnant or planning to
become pregnant and want to stop smoking. Most doctors will recommend that you
try other ways to stop smoking before using nicotine replacement.

If you have a
health condition, such as mental illness or heart problems, or if you take medicine for a mental health problem, be sure to talk to your doctor before you use nicotine replacement products.

Some studies have found that
varenicline (Chantix) works better than
bupropion SR (Zyban) and nicotine replacement.2, 3 But
every person is different. So one medicine may work better for you than the
other.

All forms of
nicotine replacement products work about equally well
when used in the right way.4

Your chances
of quitting smoking are even better if you combine the patch with lozenges or gum.

Medicines that don't have nicotine

The
most common side effects of
varenicline (Chantix) include:

Nausea.

Increased dreaming.

Trouble sleeping.

Some people also have side effects such as headaches and dizziness.

Chantix may be linked with a small increase in risk for heart problems (including heart attack). Call your doctor if you have any cardiovascular disease symptoms that are new or getting worse, such as chest pain or pressure, shortness of breath, calf pain when walking, or sudden onset of weakness, numbness, or difficulty speaking.

Some people who take
bupropion SR (Zyban) have:

Dry mouth.

Trouble
sleeping.

There is a small risk of having
seizures when you use bupropion. The risk increases if
you have had a head injury or seizures.

Tell your doctor about
all the medicines you take. When you stop smoking, there may be a change in how
other medicines work for you.

FDA warning. The U.S. Food and
Drug Administration (FDA) warns that people who are taking bupropion (Zyban) or varenicline (Chantix) and who experience any serious or unusual changes in mood or behavior or who feel like hurting themselves or someone else should stop taking the medicine and call a doctor right away. If you already have a mood or behavior problem, be sure to tell your doctor before you decide to use these medicines.

Nicotine replacement products

The side effects depend on the type of
nicotine replacement product.

Nicotine patches can
cause itching and redness where you put the patch. If you use a 24-hour patch,
you may have trouble sleeping or have very vivid dreams. This is because your
brain isn't used to getting nicotine when you're sleeping. Taking off the patch
a few hours before you go to sleep usually helps ease your sleep problems.

Nicotine gum can cause an upset stomach (nausea) or heartburn.
Gum is not a good choice for people who have dentures or problems with their
jaw joint (TM disorders).

Personal stories from people who have quit smoking

These stories are based on information gathered from health professionals and consumers. They may be helpful as you make important health decisions.

I started
smoking when I was in the military. But it is affecting my health, and I want
to quit. I've tried the patch, gum, and cold-turkey methods to quit, and they
didn't work. So I talked with my doctor about quitting, and he suggested that I
try using Chantix. He also recommended that I have counseling and join a
support group. It's been a little over a month since I started Chantix, and so
far it is helping with my craving to smoke. Talking in counseling is also
helpful. I think I finally am going to be able to quit.

Dave, age 42

I thought about taking medicine to quit
smoking, but I already take several other medicines for health problems. I just
didn't want to take another prescription medicine and take the chance that it
might cause problems. So I decided to try the nicotine patch. I set a date and
started planning for the physical effects of quitting, like having munchies
around and cleaning my car and house. I started with the largest patch
available. It was great because the withdrawal symptoms were hardly noticeable.
Then I went to the medium patch and finally the smallest patch. Now I don't
smoke anymore.

Alanna,
age 44

I started smoking at 15. I always thought I could quit at any time
and had tried to quit dozens of times. But then I'd start craving a smoke, and
I'd go back to cigarettes. A few years ago, my doctor suggested I try taking
Zyban and nicotine gum. It was great, because
between the pills and the gum, the withdrawal symptoms
were hardly noticeable. I was done with the gum after the first few
weeks, but I ended up staying on the pills for 6 months. But using both worked
for me, and I haven't smoked for 2 years.

Carlo, age 52

My friends
pushed me to quit smoking and suggested I talk to my doctor about getting some
medicine to help. But I just wasn't comfortable with the idea of taking
medicine. I have a strong will, and when I put my mind to doing something, I
can usually do it. So I took my doctor's advice to have professional counseling
to help improve my chances of success. I quit smoking—cold turkey—5 months ago.
All my friends are really surprised that I could quit like that. It has been
tough at times fighting the cravings, but it has worked.

Kesia, age
35

What matters most to you?

Your personal feelings are just as important as the medical facts. Think about what matters most to you in this decision, and show how you feel about the following statements.

Reasons to use medicine to quit smoking

Reasons not to use medicine

I want to use medicine if it can increase my chances of quitting.

I don't like using medicine.

More important

Equally important

More important

I'm not concerned about possible side effects.

I am very concerned about side effects.

More important

Equally important

More important

I'm not worried about how I will pay for the medicine.

I'm worried about how I will pay for the medicine.

More important

Equally important

More important

My other important reasons:

My other important reasons:

More important

Equally important

More important

Where are you leaning now?

Now that you've thought about the facts and your feelings, you may have a general idea of where you stand on this decision. Show which way you are leaning right now.

FalseSorry, that's not right. Using medicine can double your chances of quitting smoking. It can relieve nicotine withdrawal symptoms.

I'm not sureIt may help to go back and read "Get the Facts." Using medicine can double your chances of quitting smoking. It can relieve nicotine withdrawal symptoms.

2.

My chances of quitting are even better if I get counseling along with using medicine.

TrueThat's right. Counseling and medicine together can increase your chances of quitting even more.

FalseNo, that's not right. Counseling and medicine together can increase your chances of quitting even more.

I'm not sureIt may help to go back and read "Get the Facts." Counseling and medicine together can increase your chances of quitting even more.

3.

I shouldn't use nicotine replacement products, because they're just as bad as the nicotine in cigarettes.

TrueThat's not right. Nicotine is addictive. But by itself, it's not nearly as harmful as smoking. Tars, carbon monoxide, and other toxic chemicals in tobacco cause the harmful effects.

FalseYou're right. Nicotine is addictive. But by itself, it's not nearly as harmful as smoking. Tars, carbon monoxide, and other toxic chemicals in tobacco cause the harmful effects.

I'm not sureIt may help to go back and read "Get the Facts." Nicotine is addictive. But by itself, it's not nearly as harmful as smoking. Tars, carbon monoxide, and other toxic chemicals in tobacco cause the harmful effects.

You may want to have a say in this decision, or you may simply want to follow your doctor's recommendation. Either way, this information will help you understand what your choices are so that you can talk to your doctor about them.

Quitting Smoking: Should I Use Medicine?

Here's a record of your answers. You can use it to talk with your doctor or loved ones about your decision.

Get the facts

Compare your options

What matters most to you?

Where are you leaning now?

What else do you need to make your decision?

1. Get the Facts

Your options

Use medicine to help you quit smoking. This may include
nicotine replacement products.

Don't use medicine.

Key points to remember

Using medicines and nicotine replacement products (patches, gum, lozenges, and inhalers) can double your chances of quitting
smoking.1 They can relieve
nicotine craving and withdrawal symptoms.

Getting counseling, along with using medicine, can increase your
chances of quitting even more.

If you smoke fewer than 10
cigarettes a day, you may not need medicines to help you quit smoking.

It's rare for someone to get addicted to nicotine medicines,
because the nicotine is released slowly at low levels into your bloodstream.

Nicotine replacement products may cause some side effects, such as problems with sleep or red and itchy skin with the patch. Medicines in pill form
can cause nausea, dry mouth, and trouble sleeping. For most people, the side
effects aren't bad enough to make them stop using the medicines.

Nicotine medicines have less than half of the nicotine than cigarettes. And by
itself, nicotine is not nearly as harmful as smoking. The tars, carbon
monoxide, and other toxic chemicals in tobacco cause the harmful effects.

Many insurance companies will pay for all or part of the cost of
medicines used to quit smoking.

FAQs

What are the medicines?

Your doctor may prescribe
varenicline (Chantix) or bupropion (Zyban) to help you cope with cravings for
tobacco. These medicines are pills that don't contain nicotine. You also can
use nicotine replacement products, which do contain nicotine.

Medicines that don't have nicotine

Varenicline (Chantix) blocks the effects of nicotine and reduces cravings and
withdrawal symptoms. If you start smoking again while
you are taking the medicine, you won't feel as satisfied. This improves your
chances of quitting. You start taking the medicine about a week before you quit
smoking, and you take it for 12 to 24 weeks. You take it 2 times a day, after
meals.

Bupropion SR (Zyban) can help
balance chemicals in your brain to reduce your withdrawal symptoms. Doctors
also prescribe this medicine (under the brand name Wellbutrin) to treat
depression. But it can help you stop smoking even if
you don't have depression. You start taking bupropion daily about 1 to 2 weeks
before you quit smoking. You
keep taking it for 7 to 12 weeks after you stop smoking.

Nicotine replacement products

Nicotine replacement gives your body
some nicotine to help reduce withdrawal symptoms and cravings. Nicotine is
addictive. But this treatment has about one-third to one-half the amount of
nicotine in most cigarettes. It also delivers the nicotine slowly, so it rarely causes addiction. And these products don't have the
harmful tars, carbon monoxide, and other toxic chemicals that are in tobacco.

An inhaler has a holder that contains nicotine. It delivers a
puff of nicotine vapor into your mouth and throat.

Nicotine nasal spray (Nicotrol) is another nicotine replacement. But because of its side effects, it is not widely used. See your doctor about this medicine.

You can buy nicotine gum, patches, and lozenges without a
prescription. You need a prescription to buy inhalers. You may be able to use a
couple of these products at the same time, such as a patch and gum. But talk to
your doctor first to make sure it's okay to mix nicotine medicines. People
younger than age 18 can't buy the
over-the-counter products, but a doctor may prescribe
them.

Talk to your doctor if you're pregnant or planning to
become pregnant and want to stop smoking. Most doctors will recommend that you
try other ways to stop smoking before using nicotine replacement.

If you have a
health condition, such as mental illness or heart problems, or if you take medicine for a mental health problem, be sure to talk to your doctor before you use nicotine replacement products.

How well do medicines work?

Some studies have found that
varenicline (Chantix) works better than
bupropion SR (Zyban) and nicotine replacement.2, 3 But
every person is different. So one medicine may work better for you than the
other.

All forms of
nicotine replacement products work about equally well
when used in the right way.4

Your chances
of quitting smoking are even better if you combine the patch with lozenges or gum.

What are the risks of using medicine to quit smoking?

Medicines that don't have nicotine

The
most common side effects of
varenicline (Chantix) include:

Nausea.

Increased dreaming.

Trouble sleeping.

Some people also have side effects such as headaches and dizziness.

Chantix may be linked with a small increase in risk for heart problems (including heart attack). Call your doctor if you have any cardiovascular disease symptoms that are new or getting worse, such as chest pain or pressure, shortness of breath, calf pain when walking, or sudden onset of weakness, numbness, or difficulty speaking.

Some people who take
bupropion SR (Zyban) have:

Dry mouth.

Trouble
sleeping.

There is a small risk of having
seizures when you use bupropion. The risk increases if
you have had a head injury or seizures.

Tell your doctor about
all the medicines you take. When you stop smoking, there may be a change in how
other medicines work for you.

FDA warning. The U.S. Food and
Drug Administration (FDA) warns that people who are taking bupropion (Zyban) or varenicline (Chantix) and who experience any serious or unusual changes in mood or behavior or who feel like hurting themselves or someone else should stop taking the medicine and call a doctor right away. If you already have a mood or behavior problem, be sure to tell your doctor before you decide to use these medicines.

Nicotine replacement products

The side effects depend on the type of
nicotine replacement product.

Nicotine patches can
cause itching and redness where you put the patch. If you use a 24-hour patch,
you may have trouble sleeping or have very vivid dreams. This is because your
brain isn't used to getting nicotine when you're sleeping. Taking off the patch
a few hours before you go to sleep usually helps ease your sleep problems.

Nicotine gum can cause an upset stomach (nausea) or heartburn.
Gum is not a good choice for people who have dentures or problems with their
jaw joint (TM disorders).

You could have side effects.
These depend on the type of medicine. Side effects may include:

Nausea.

Vivid
dreams.

Dry mouth.

Trouble
sleeping.

Itching and redness where the patch is
placed.

Heartburn.

Headaches.

Cough.

Quitting on
your own might not work.

Personal stories

Are you interested in what others decided to do? Many people have faced this decision. These
personal stories
may help you decide.

Personal stories from people who have quit smoking

These stories are based on information gathered from health professionals and consumers. They may be helpful as you make important health decisions.

"I started smoking when I was in the military. But it is affecting my health, and I want to quit. I've tried the patch, gum, and cold-turkey methods to quit, and they didn't work. So I talked with my doctor about quitting, and he suggested that I try using Chantix. He also recommended that I have counseling and join a support group. It's been a little over a month since I started Chantix, and so far it is helping with my craving to smoke. Talking in counseling is also helpful. I think I finally am going to be able to quit."

— Dave, age 42

"I thought about taking medicine to quit smoking, but I already take several other medicines for health problems. I just didn't want to take another prescription medicine and take the chance that it might cause problems. So I decided to try the nicotine patch. I set a date and started planning for the physical effects of quitting, like having munchies around and cleaning my car and house. I started with the largest patch available. It was great because the withdrawal symptoms were hardly noticeable. Then I went to the medium patch and finally the smallest patch. Now I don't smoke anymore."

— Alanna,
age 44

"I started smoking at 15. I always thought I could quit at any time and had tried to quit dozens of times. But then I'd start craving a smoke, and I'd go back to cigarettes. A few years ago, my doctor suggested I try taking Zyban and nicotine gum. It was great, because between the pills and the gum, the withdrawal symptoms were hardly noticeable. I was done with the gum after the first few weeks, but I ended up staying on the pills for 6 months. But using both worked for me, and I haven't smoked for 2 years."

— Carlo, age 52

"My friends pushed me to quit smoking and suggested I talk to my doctor about getting some medicine to help. But I just wasn't comfortable with the idea of taking medicine. I have a strong will, and when I put my mind to doing something, I can usually do it. So I took my doctor's advice to have professional counseling to help improve my chances of success. I quit smoking—cold turkey—5 months ago. All my friends are really surprised that I could quit like that. It has been tough at times fighting the cravings, but it has worked."

— Kesia, age
35

"The first time I tried to quit, I went cold turkey. It only lasted a week. The next time I tried some kind of gum. This was in the '70s or '80s, so it was whatever kind of gum was available then, probably not the same as nicotine gum now. I quit smoking for a year that time, but I always craved cigarettes. The third time was right before I turned 60. I used Zyban and the nicotine patch for 6 weeks. I'm amazed at how well it worked. I have had no cravings for cigarettes, even from the very first day when I had my morning coffee. My father-in-law told me that, even 20 years after quitting, he still craved cigarettes every day, so that's what I was expecting. I didn't even throw away my cigarettes because I didn't expect it to work, but it worked incredibly well."

— Roy, age 63

"I started smoking at 13. I always thought I could quit at any time. But at 33 I was smoking a pack a day and had tried to quit dozens of times. I tried cold turkey. I was so grumpy I made a waiter cry. I tried hypnosis. It didn't work. I tried nicotine gum. It didn't work either. Finally, I tried the patch. I started with the largest one available. It was great because the withdrawal symptoms were hardly noticeable. Then I went to the medium patch and finally the smallest patch. I was really nervous about taking off that last patch. But I'd tapered off the nicotine so much that I had no withdrawal symptoms. That was nearly 12 years ago and I'm still smoke-free."

— Nancy, age 46

"Cigarettes were my best friend. They went on all my traveling adventures and they were there for me when I needed them, through heartbreaks, frustrations, and new jobs—20 years of companionship. I set a date and started planning. I bit the bullet and sent an e-mail out to all my friends and family, and I was floored by the support I got. A friend recommended acupuncture, so I made an appointment. For added incentive, I added daily exercise and a dog to my "new life." It has been 4 months and I am still a nonsmoker. I had daily cravings for the first 2 weeks, but now I go entire days without even thinking about cigarettes. If I ever start feeling on the edge, I will head right back to the acupuncturist for a tune-up!"

— Leta, age 35

"I quit smoking cold turkey 3 months ago. All my friends are really surprised that I quit. I mean, I would wake up every 2 hours at night to smoke a cigarette. People just identified me with smoking. I finally decided it was time to quit when I couldn't catch my breath walking up stairs. Other than gaining a few pounds, it really hasn't been bad."

— Ian, age 52

3. What matters most to you?

Your personal feelings are just as important as the medical facts. Think about what matters most to you in this decision, and show how you feel about the following statements.

Reasons to use medicine to quit smoking

Reasons not to use medicine

I want to use medicine if it can increase my chances of quitting.

I don't like using medicine.

More important

Equally important

More important

I'm not concerned about possible side effects.

I am very concerned about side effects.

More important

Equally important

More important

I'm not worried about how I will pay for the medicine.

I'm worried about how I will pay for the medicine.

More important

Equally important

More important

My other important reasons:

My other important reasons:

More important

Equally important

More important

4. Where are you leaning now?

Now that you've thought about the facts and your feelings, you may have a general idea of where you stand on this decision. Show which way you are leaning right now.

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